Document Detail

Inner ear decompression sickness in compressed-air diving.
MedLine Citation:
PMID:  22400449     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Inner ear decompression sickness (IEDCS) has become more frequently reported in recreational diving.
METHODS: We examined 34 divers after IEDCS and analyzed their dive profiles, pattern of symptoms, time of symptom onset and the association with a right-to left shunt (r/l shunt).
RESULTS: Four divers used mixed gas and were excluded from the analysis. Of the remaining 30 divers, 25 presented with isolated IEDCS alone, while five divers had additional skin and neurological symptoms. All divers presented with vertigo (100%), and 12 divers reported additional hearing loss (40%). All symptoms occurred within 120 minutes (median 30 minutes) of ascent. Twenty-two of 30 divers (73.3%) showed a r/l shunt.
CONCLUSION: A possible explanation for the frequent association of a r/l shunt and the dominance of vestibular rather than cochlear symptoms could be attributed to the different blood supply of the inner ear structures and the different size of the labyrinthine compartments. The cochlea has a blood supply up to four times higher than the vestibular part of the inner ear, whereas the vestibular fluid space is 30% larger. The higher prevalence of symptoms referrable to the less well-perfused vestibular organ provides further evidence that persistent local inert gas supersaturation may cause growth of incoming arterial bubbles and may therefore be an important pathophysiological factor in IEDCS.
Christoph Klingmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc     Volume:  39     ISSN:  1066-2936     ISO Abbreviation:  Undersea Hyperb Med     Publication Date:    2012 Jan-Feb
Date Detail:
Created Date:  2012-03-09     Completed Date:  2012-03-13     Revised Date:  2012-08-22    
Medline Journal Info:
Nlm Unique ID:  9312954     Medline TA:  Undersea Hyperb Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  589-94     Citation Subset:  IM; S    
Department of Otolaryngology, Head & Neck Surgery, University of Heidelberg, Germany.
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MeSH Terms
Cochlea / blood supply
Compressed Air
Coronary Circulation
Decompression Sickness / etiology*
Diving / adverse effects*
Ear Diseases / etiology*
Ear, Inner* / blood supply
Hearing Loss / etiology
Leisure Activities
Middle Aged
Pulmonary Circulation
Regional Blood Flow / physiology
Retrospective Studies
Time Factors
Tinnitus / etiology
Vertigo / etiology
Vestibule, Labyrinth / blood supply
Comment In:
Undersea Hyperb Med. 2012 Jul-Aug;39(4):867; author reply 867-8   [PMID:  22908843 ]

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